Manager, Insurance Operations

Seattle, OR - USA

Monthly Salary: $ 101600 - 152400

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

At Adaptive were Powering the Age of Immune Medicine. Our goal is to harness the power of the adaptive immune system to transform the way diseases are diagnosed and treated.

As an Adapter youll have the opportunity to make a difference in peoples lives. With Adaptive youll create a career highlight through collaboration with bright curious colleagues working at the apex of innovation and application.

Its time for your next chapter. Discover your story with Adaptive.

Position Overview

Manager of Insurance Operations is responsible for overseeing all activities related to contracted payer denials underpaid claims and insurance follow-up processes prior to any formal appeal process. This role ensures timely resolution of reimbursement issues manages and distributes work queues and drives operational efficiency in handling claims and agreements. The manager will also lead efforts related to Letters of Agreement (LOA) and Single Case Agreements (SCA) with non-contracted payers to secure appropriate reimbursement.

Leaders at Adaptive demonstrate behaviors consistent with Adaptives Core Values and Leadership Principles. Critical functions of your role include helping establish individual team member goals aligning those individual goals with broader team objectives and ensuring those objectives drive the achievement of company goals. Providing thoughtful coaching and consistent feedback to your team members will drive performance excellence and accountability as well as support your team members growth and development. Leaders at Adaptive create an environment of belonging respect and open and honest communication every day.

Key Responsibilities and Essential Functions

Denials & Underpayments Management

Oversee workflows for contracted payer denials and underpaid claims.
Develop and implement strategies to reduce denials and recover underpayments.
Monitor denial trends and collaborate with internal teams to address root causes.
Collaborate with payer relations and contracting teams for denial trends.

Insurance Follow-Up Oversight

Manage insurance follow-up queues to ensure timely and accurate responses to payer requests.
Establish performance metrics and monitor team productivity for follow-up activities.
Serve as an escalation point for complex payer issues.

Non-Contracted Payer Agreements

Oversee negotiation and execution of Letters of Agreement and Single Case Agreements with non-contracted payers.
Ensure agreements are documented compliant and aligned with organizational reimbursement goals.

Leadership & Team Development

Manage and mentor team responsible for denials underpayments and payer follow-up.
Provide training and guidance to ensure adherence to policies and best practices.
Foster a culture of accountability collaboration and continuous improvement.

Reporting & Analytics

Prepare and analyze reports on denial rates recovery performance and payer trends.
Present findings and recommendations to senior leadership for process optimization.

All other duties as assigned

Position Requirements (Education Experience Other)

Required

Bachelors degree in Healthcare Administration Business or related field (or equivalent experience).
8 years of experience in reimbursement operations revenue cycle management or payer relations.
Strong knowledge of insurance billing payer contracts and reimbursement methodologies.
Proven leadership experience with the ability to manage teams and drive performance.
Excellent communication negotiation and problem-solving skills.
Proficiency in revenue cycle systems (Quadax preferred) and Microsoft Office Suite.

Preferred

Experience with LOA/SCA negotiations.
Familiarity with denial management tools and payer portals.
Analytical mindset with the ability to interpret complex data and trends.

#LI-Remote

Compensation

Salary Range: $101600 - $152400

Other compensation elements include:

equity grant
bonus eligible

ALERT: Malicious groups posing as Adaptive employees have recently used fraudulent email aliases to extend employment offers provide fake documents and request sensitive personal and financial information. Legitimate Adaptive employment opportunities are initiated through our careers page and extended after multiple interviews with verified employees. Adaptive does not ask new hires to purchase anything out-of-pocket including home office supplies and equipment.

Interested in this position but dont meet all the requirements Adaptive is committed to building diverse equitable and inclusive teams across our organization. Please consider applying even if your experience doesnt match all the qualifications; you may be the exact candidate were searching for!

Adaptive is not currently sponsoring candidates requiring work authorization support for this position.

Adaptives posted compensation information includes a base salary (or hourly rate) range and summary of other available total compensation. The base salary range represents a minimum-to-maximum salary (or hourly rate) available to candidates upon extension of offer. Base salary is thoughtfully considered upon offer and is determined through multiple evaluation checks throughout the interview process including: a candidates ability to meet minimum qualifications (skills/experience/education) a candidates ability to thoughtfully address preferred qualifications current market conditions and internal pay equity. Listed base salary is exclusive of bonus commission equity differential pay benefits and other incentives.

Adaptives benefits at-a-glance.

Adaptive Biotechnologies is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin or protected veteran status and will not be discriminated against based on disability. Please refer theKnow Your Rights: Workplace Discrimination is Illegal Posterfor more information. If youd like to view a copy of the companys affirmative action plan or policy statement please email .

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NOTE TO EMPLOYMENT AGENCIES: Adaptive Biotechnologies values our relationships with our Recruitment Partners and will only accept resumes from those partners who have active agreements with Adaptive. Adaptive Biotechnologies is not responsible for any fees related to resumes that are unsolicited or are received by any employee of Adaptive Biotechnologies who is not a member of the Human Resources team.

Required Experience:

Manager

At Adaptive were Powering the Age of Immune Medicine. Our goal is to harness the power of the adaptive immune system to transform the way diseases are diagnosed and treated.As an Adapter youll have the opportunity to make a difference in peoples lives. With Adaptive youll create a career highlight t...